Long-term results of infrainguinal revascularization with polytetrafluoroethylene: A ten-year experience

William J. Quiñones-Baldrich, Alfredo A. Prego, Roberto Ucelay-Gomez, Julie A. Freischlag, Samuel S. Ahn, J. Dennis Baker, Herbert I. Machleder, Wesley S. Moore

Research output: Contribution to journalArticle

117 Scopus citations

Abstract

Two hundred fifty-eight patients underwent 322 infrainguinal revascularizations with use of polytetrafluoroethylene (PTFE) between 1978 and 1988. The indication was limb salvage in 190 (59%) reconstructions. Two hundred nineteen (68%) were above-knee, and 75 (23%) were below-knee femoropopliteal bypasses. Twenty-eight (8.6%) were femoralinfrapopliteal bypasses, all done for limb salvage. Follow-up ranged from 24 to 144 months (mean, 66 months). The perioperative mortality rate (1 to 30 days) was 3.4% (9 patients), with no significant difference according to indication (2.9% vs 3.7%). Actuarial primary patency at 8 years for the entire series of femoropopliteal bypasses was 53% (above knee 53%; below knee 39%; p < 0.05), and improved with additional procedures for a secondary patency of 72%. Femoropopliteal bypasses done for severe claudication had an 8-year actuarial primary patency of 63%, compared with 38% for limb salvage (p < 0.02). Actuarial limb salvage in the latter group at 8 years was 66%. Femoral-infrapopliteal reconstructions with PTFE had a significantly lower primary patency at 3 years (22%, with a 37% limb salvage). Sixty-four percent of the failures for all reconstructions (N = 111) occurred within 12 months, with remarkable stabilization of patency curves beyond that interval. This experience represents the largest reported series of PTFE reconstruction with longest follow-up to date and may serve as a basis for comparison of other conduits. These results suggest an important role for PTFE in femoropopliteal revascularization and a limited role of this prosthetic conduit in femoral-infrapopliteal arterial reconstructions.

Original languageEnglish (US)
Pages (from-to)209-217
Number of pages9
JournalJournal of Vascular Surgery
Volume16
Issue number2
DOIs
StatePublished - 1992

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

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    Quiñones-Baldrich, W. J., Prego, A. A., Ucelay-Gomez, R., Freischlag, J. A., Ahn, S. S., Baker, J. D., Machleder, H. I., & Moore, W. S. (1992). Long-term results of infrainguinal revascularization with polytetrafluoroethylene: A ten-year experience. Journal of Vascular Surgery, 16(2), 209-217. https://doi.org/10.1016/0741-5214(92)90109-L